CN212699096U - Pedicle screw placing guide plate - Google Patents

Abstract

The utility model provides a nail baffle is put to pedicle of vertebral arch, what its was prepared puts that the nail baffle can be safe accurate puts into pedicle of vertebral arch screw, reduces operation risk and wound, improves patient quality of life, and it includes spreader, side pillar and needle track post, and the both ends of spreader are provided with the needle way, and every needle track perpendicular downwardly extending is provided with the side pillar, and every needle track slant downwardly extending is provided with the needle track post, and side pillar and needle track post input end altogether, and the inner chamber and the needle track of needle track post link up.

Description

Pedicle screw placing guide plate

Technical Field

The utility model relates to a medical instrument field particularly, relates to a nail baffle is put to pedicle of vertebral arch.

Background

In the prior art, pedicle screw placement is the basis of a posterior internal fixation operation of the spine and is a key step, precise pedicle screw placement is particularly important in reducing complications and ensuring curative effects, and biomechanics experiments prove that ideal fixation effects can be obtained only by placing screws along the anatomical long axis of the pedicle and achieving ideal depth.

Due to factors such as complex anatomical structure of the spine, individual difference of patients, skill level of operators and the like, the traditional bare-handed nail placing technology is easy to deviate in finding a nail feeding point and a nail placing direction, so that the fixing effect is influenced, the operation time is prolonged, the operation trauma and bleeding, the infection rate and the pain of an operation area are increased, and the spinal cord, nerve roots, blood vessels and the like of the patients are damaged seriously.

At present, the main methods for determining the pedicle screw feeding angle and the pedicle screw feeding point include: anatomical landmark point method, X-ray fluoroscopy method, computer navigation method, and navigation template method. The nail feeding point and the nail feeding angle of the anatomical point marking method are mainly judged by the experience of an operator, the requirement on the clinical experience of a doctor is high, and the precision is difficult to guarantee. The operation time of the X-ray fluoroscopy-assisted method is long, and the radiation exposure of patients and medical staff is increased. The computer navigation method guides the operation by utilizing the real-time pedicle image information of the patient, has great advantages, but has expensive equipment price, difficult operation and difficult popularization. With the application of the 3D printing navigation template, various domestic and foreign researches prove that the technology has higher accuracy in the screw placement of each segment vertebral pedicle, and the probability of mistaken screw entry into the vertebral canal and cortical penetration is obviously reduced. However, the guide plate of the conventional design needs to be stripped and removed more of the soft tissue in order to be as close to the bone surface as possible, and some problems of nail placement by hands still occur.

SUMMERY OF THE UTILITY MODEL

An object of the utility model is to provide a nail baffle is put to pedicle of vertebral arch, what its preparation was put the nail baffle can be safe accurate puts into pedicle of vertebral arch screw, reduces operation risk and wound, improves patient quality of life.

The embodiment of the utility model is realized like this:

the utility model provides a pedicle of vertebral arch puts nail baffle, its includes spreader, side column and needle way post, and the both ends of spreader are provided with the needle way, and every needle way perpendicular downwardly extending is provided with the side column, and every needle way slant downwardly extending is provided with the needle way post, and side column and needle way post common input end, the inner chamber and the needle way of needle way post link up.

In the preferred embodiment of the present invention, the pedicle screw guide plate further comprises a diagonal strut extending from the middle of the needle track post or the side post, and the diagonal strut has an inclination angle with the needle track post or the side post.

In a preferred embodiment of the present invention, the top of the horizontal pillar is a plane, and the bottom surface of the horizontal pillar is a bone-engaging surface.

In a preferred embodiment of the present invention, the output end surfaces of the side pillars, the needle path pillars, and the diagonal bracing pillars are bone-engaging surfaces.

In a preferred embodiment of the present invention, the cross pillars, the side pillars, and the diagonal braces are hollow.

In a preferred embodiment of the present invention, the cross-post has a cross-post hole formed in the middle thereof.

In a preferred embodiment of the present invention, the pedicle screw guide plate further comprises a puncture needle, the puncture needle enters from the needle channel and passes through the needle channel column to enter the puncture position of the pedicle, the tail of the puncture needle is provided with a clamping portion, and the needle body of the puncture needle is provided with scales.

In a preferred embodiment of the present invention, the puncture needle includes an open needle and an open needle, the open needle has a sharp tip, and the open needle has a blunt tip.

In a preferred embodiment of the present invention, the cross post, the side post, the needle path post and the diagonal brace post are integrally formed.

The embodiment of the utility model provides a beneficial effect is: the two ends of the transverse column of the pedicle screw-placing guide plate of the utility model are provided with the side columns, the upper ends of the side columns are partially overlapped with the needle path column part, and the lower ends of the side columns are attached and matched with the outline of the upper articular process bone surface; the needle path column is used for placing a needle, and meanwhile, a bone binding surface at the lower end of the needle path column is positioned at the optimal nail feeding point; meanwhile, an inclined strut is arranged, and a bone binding surface of the inclined strut is positioned at the outer edge of the vertebral arch isthmus; therefore, the pedicle screw placing guide plate adopts a door-shaped structure to enable the guide plate to be attached to bone surfaces on two sides, the two sides are positioned simultaneously, the guide plate is placed more stably, the positioning is more accurate, and the stripping surface of soft tissues is smaller. By means of the portal tree fork-shaped pedicle screw placing guide plate and the matched puncture needle, an operator can quickly and accurately place screws in a pedicle internal fixation operation, the complex operation is simplified, and the instrument cost is low.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings that are required to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention, and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.

FIGS. 1-3 are schematic views showing the structure of the nail-placing guide plate according to the embodiment of the present invention in various directions;

FIG. 4 is a schematic view of a puncture needle according to an embodiment of the present invention;

icon: 100-transverse column; 200-side columns; 300-needle track column; 110-needle track; 120-cross-post opening; 400-bracing struts; 500-puncture needle; 510-a clamping portion; 501-opening needle; 502-open needle.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention, as generally described and illustrated in the figures herein, may be arranged and designed in a wide variety of different configurations.

Thus, the following detailed description of the embodiments of the present invention, presented in the accompanying drawings, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative efforts belong to the protection scope of the present invention.

It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.

In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", and the like indicate the position or positional relationship based on the position or positional relationship shown in the drawings, or the position or positional relationship which is usually placed when the product of the present invention is used, and are only for convenience of description and simplification of the description, but do not indicate or imply that the device or element referred to must have a specific position, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," "third," and the like are used solely to distinguish one from another and are not to be construed as indicating or implying relative importance.

Furthermore, the terms "horizontal", "vertical", "overhang" and the like do not imply that the components are required to be absolutely horizontal or overhang, but may be slightly inclined. For example, "horizontal" merely means that the direction is more horizontal than "vertical" and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.

In the description of the present invention, it should also be noted that, unless otherwise explicitly specified or limited, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present invention can be understood in specific cases to those skilled in the art.

First embodiment

Referring to fig. 1-3, the present embodiment provides a pedicle screw guide plate, which includes a cross-post 100, side-posts 200, and needle track posts 300, wherein needle tracks 110 are disposed at two ends of the cross-post 100, each needle track 110 is vertically extended downward and provided with a side-post 200, each needle track 110 is obliquely extended downward and provided with a needle track post 300, the side-posts 200 and the needle track posts 300 share an input end, and an inner cavity of the needle track post 300 is communicated with the needle track 110. The pedicle screw guide plate further comprises an inclined strut support 400, the inclined strut support 400 extends out from the middle of the needle path column 300 or the side column 200, and an inclination angle exists between the inclined strut support 400 and the needle path column 300 and between the inclined strut support 400 and the side column 200 respectively. The output end surfaces of the side posts 200, the needle way posts 300 and the bracing strut 400 are bone-engaging surfaces.

In the embodiment, the two ends of the transverse column 100 are provided with the side columns 200, and the needle path columns 300 are attached to the side columns 200, so that the pedicle screw placing guide plate is portal-shaped, the screw placing guide plate is attached to bone surfaces on two sides, the two sides are positioned simultaneously, and the guide plate is positioned more accurately and more stably; the bone binding surface of the side column 200 is bound with the upper articular process of the target vertebral body, the bone binding surface of the needle track column 300 is bound with the optimal nail feeding point of the target vertebral body, and the bone binding surface of the diagonal bracing strut 400 is positioned at the outer edge of the vertebral arch isthmus, so that the side column 200, the needle track column 300 and the diagonal bracing strut 400 are distributed in a crotch shape, the guide plate is placed more stably, and meanwhile, the requirement on the stripping surface of soft tissue is lower.

More specifically, the spreader 100 in this embodiment is a cylindrical structure with a diameter of 10mm, the top of the spreader 100 is a needle threading plane, the needle threading plane is a horizontal plane, and the top of the spreader 100 is set as a horizontal cutting plane, so that the guide plate can be placed in a stable inverted state during 3D printing. Two ends of the horizontal column 100 are respectively provided with a needle passage 110, and the needle passages 110 are communicated to the optimal nail feeding point along the needle passage column 300. The middle part of the cross post 100 is provided with a cross post opening 120, the diameter of the cross post opening 120 is 7mm, the cross post opening 120 is a weakening hole, and the strength of the cross post 100 after the hole is formed cannot be greatly influenced. The cross-post opening 120 is used for shearing the cross-post 100 from the weakened opening after the puncture needle is successfully inserted, so that the guide plate can be conveniently removed without removing the puncture needle, and the puncture needle is temporarily left, so that the puncture point can be quickly found.

The side pillar 200 in this embodiment is a cylindrical structure with a diameter of 10mm, the upper end of the side pillar 200 is connected with the cross pillar 100, the body part is partially overlapped with the needle track pillar 300, and the lower end is attached and matched with the contour of the upper articular process bone surface. The outer side of the side post 200 is also marked with an identifier, the left side surface of the left side post 200 in the embodiment is marked with the name of the patient and information of the vertebral body segment, and the right side surface of the right side post 200 is marked with hospital identifier information. Therefore, preoperative safety check can be performed more intuitively, and error events are prevented from occurring.

In the present embodiment, the top of the needle track column 300 coincides with the side column 200, the needle track column 300 is hollow and is communicated with the needle track 110, the bottom of the needle track column 300 is a bone contact surface, and the output end orifice of the needle track column 300 is located at the optimal nail feeding point; referring to fig. 4, in the embodiment, a puncture needle 500 is matched, the puncture needle 500 enters from the needle channel 110 and passes through the needle channel column 300 to enter the puncture position of the pedicle of vertebral arch, the tail part of the puncture needle 500 is provided with a clamping part 510, the clamping part 510 is flattened to facilitate clamping and removing, and the needle body of the puncture needle 500 is provided with scales to facilitate grasping the depth of the needle. The puncture needle 500 has a length of 12-15cm and a diameter of 3.5 mm. The puncture needle 500 comprises an opening needle 501 and an opening needle 502, the tip of the puncture needle 500 is wedge-shaped, wherein the tip of the opening needle 501 is sharp, and the deviation of the needle channel 110 during puncture can be reduced to the greatest extent even if the needle inserting point is an inclined plane; the sharp end of the open end is blunt, effectively reducing the possibility that the open needle 502 breaks through the side wall of the pedicle cortical bone.

The bracing strut 400 in the embodiment is used for supporting the outer edge of the vertebral arch isthmus, and 1 or more inclined bracing struts 400 are arranged on each side pillar 200/needle way pillar 300, so that the nail placing guide plate is more stable, and the needle placing errors are reduced. Meanwhile, under the condition of increasing the nail placing stability, the inclined strut supporting column 400, the upper side column 200 and the needle way column 300 in the embodiment are in a forked shape, so that the guide plate does not need to be additionally printed with a supporting structure in the 3D printing process, and the printing efficiency and the one-time forming probability are improved.

In the preferred embodiment of the present invention, the above-mentioned in the preferred embodiment of the present invention, the inside cavity of the above-mentioned spreader beam 100, side pillar 200 and bracing pillar 400 is put the nail baffle and is adopted 3D to print technology integrated into one piece, has still guaranteed the steadiness of putting the nail baffle when reducing to put nail baffle self weight.

Correspondingly, the embodiment also provides a preparation method of the pedicle screw placing guide plate, which comprises the following steps:

step one, establishing a vertebra model, acquiring a CT image of a target vertebra of a patient, and importing the image into 3D modeling software to establish a 3D model of the target vertebra; in the embodiment, the layer thickness of the CT image of the target vertebra is not less than 1.5mm, and the 3D modeling software adopts the mimics 20.0 software;

step two, establishing a pedicle screw-placing guide plate model, planning an optimal screw feeding point and direction of a preset screw on the 3D model of the target vertebra by using a cylinder with the diameter of 4mm in 3D modeling software, establishing a needle way column 300 to wrap the cylinder, sequentially establishing a transverse column 100, a side column 200 and an inclined strut support column 400, and combining Boolean operation and plane cutting functions in the software to obtain a guide plate initial model;

and step three, molding and printing, namely, putting the initial model and the 3D model into 3D printing software for drawing, and printing and molding the initial model by using a 3D printer. Finally, the three-dimensional model of the target vertebral body and the guide plate initial model are led into 3-matic software for drawing, and then labels such as the name of a patient, the segments of the vertebral body, the name of a hospital and the like are marked on the side column 200 of the guide plate. And (5) exporting the three-dimensional model of the guide plate, and printing and molding the model by using a 3D printer. In the embodiment, an aurora brand printer based on the fused deposition type principle is selected, and due to the design advantage of the guide plate, even a 3D printer based on the original fused deposition type principle has an extremely high one-step forming rate.

The pedicle screw guide plate in the embodiment is used as follows:

1. after the nail placing guide plate is manufactured, low-temperature plasma sterilization is performed on the nail placing guide plate before operation, and the operation is prepared after the patient information marked on the guide plate is checked to be correct; the patient information in this embodiment includes, but is not limited to, the names of the academy of care (Yue TCM bone) and the names of the patients (Zhang III) as shown in FIGS. 1-3, and the patient information can be replaced with other information such as the affected part of the patient; the patient information in this embodiment is also printed by a 3d printer.

2. The bone surfaces of the upper articular process, the herringbone ridge and the outer edge of the vertebral arch isthmus of the target vertebral body are exposed in the operation, the prepared bone binding surface of the nail placing guide plate is buckled on the exposed bone surfaces, the guide plate is checked to be well attached and matched, and the installation is stable.

3. Then, a 3.5mm open needle 501 is knocked into the needle track column 300 through the needle tracks 110 on the two sides, the bone entering depth is about 0.5cm, the C arm looks through the right side position, and whether the entry point and the direction of the open needle 501 are correct is checked.

4. After confirming that no abnormity exists, clamping the clamping part 510 at the tail part of the opening needle 501 by a large vascular clamp, rotationally removing the opening needle 501 at one side, facilitating the expansion of the bone canal, knocking in the depth of the opening needle 502 by about 2cm, enabling the flat surface at the tip of the opening needle 502 to be parallel to the longitudinal line of the spine, taking out the opening needle 501 at the other side and knocking in the depth of the opening needle 502 by about 2cm by the same method, observing the front side position by the C arm again, checking whether the entry point and the direction of the opening needle 502 are correct, not breaking through the inner side wall of the vertebral pedicle on the front position sheet, and indicating the safety when the Kirschner needle tip on the side sheet approaches or reaches the back wall.

5. After confirming the correctness, continuously knocking the inserted needle for about 1-2cm, shearing the transverse column 100, pulling out the guide plate, and temporarily keeping the open needle 502 to avoid the situation that the bone opening can not be found during nail placement.

6. Clamping a clamping area at the tail part of the open circuit needle 502 by using a large vascular clamp, rotationally pulling out the open circuit needle 502 to be placed at the position of the nail, sequentially measuring the depth of a nail feeding channel and the integrity of the four walls by using a probe, tapping by using a screw tap with a proper size after determining that no abnormity exists, detecting by using the probe, and screwing in a screw with a matched specification if no abnormity exists.

7. And (5) performing C-arm positive side perspective again, and finishing the nail placing operation if the screw is not abnormal.

In conclusion, the preparation method provided by the utility model can be used for manufacturing the pedicle screw sighting device which is well matched with the target vertebra positioning curved surface in an attaching way and has a high-precision screw placing channel and can be positioned at two sides simultaneously. The operator can accurately and quickly perform the pedicle screw placing operation, thereby not only improving the operation efficiency, but also ensuring the accuracy and the safety of the operation. And simultaneously, the utility model provides an unique tree fork form overall arrangement of baffle and door type frame design, not only rational in infrastructure, intensity is higher, is difficult for taking place deformation, and very big saving 3D printing consumables shortens the printing time, has high one shot forming rate when 3D prints. The integrated guide plate with the two sides positioned simultaneously is adopted, the bone attaching area is small, soft tissue stripping with a large area is not needed, the attachment is stable, and the nail placing accuracy is powerfully guaranteed.

This description describes examples of embodiments of the invention, and is not intended to illustrate and describe all possible forms of the invention. It should be understood that the embodiments described in this specification can be implemented in many alternative forms. The figures are not necessarily to scale; some features may be exaggerated or minimized to show details of particular components. Specific structural and functional details disclosed are not to be interpreted as limiting, but merely as a representative basis for teaching one skilled in the art to variously employ the present invention. It will be appreciated by persons skilled in the art that a plurality of features illustrated and described with reference to any one of the figures may be combined with features illustrated in one or more other figures to form embodiments which are not explicitly illustrated or described. The described combination of features provides a representative embodiment for a typical application. However, various combinations and modifications of the features consistent with the teachings of the present invention may be used as desired for particular applications or implementations.

The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (9)

1. The utility model provides a pedicle of vertebral arch puts nail baffle, its characterized in that includes spreader, side pole and needle way post, the both ends of spreader are provided with the needle way, every the perpendicular downwardly extending of needle way is provided with the side pole, every needle way downwardly extending is provided with to one side the needle way post, the side pole with needle way post common input end, the inner chamber of needle way post with the needle way link up.

2. The pedicle screw guide plate according to claim 1, further comprising a bracing strut extending from a middle portion of the needle track post or the side post, wherein the bracing strut has an inclination angle with the needle track post and the side post respectively.

3. The pedicle screw guide of claim 1, wherein the top of the transverse post is a flat surface and the bottom surface of the transverse post is a bone engaging surface.

4. The pedicle screw guide of claim 2, wherein the lateral post, the needle track post and the output end surface of the strut are bone engaging surfaces.

5. A pedicle screw guide as claimed in claim 2, wherein the cross post, side posts and diagonal struts are hollow on the inside.

6. The pedicle screw guide plate according to claim 1, wherein a transverse column opening is formed in the middle of the transverse column.

7. The pedicle screw guide plate according to claim 1, further comprising a puncture needle, wherein the puncture needle enters from the needle channel and passes through the needle channel column to enter a puncture position of a pedicle, the tail part of the puncture needle is provided with a clamping part, and the needle body of the puncture needle is provided with scales.

8. A pedicle screw guide as claimed in claim 7, wherein the piercing needle comprises an open needle and an open needle, the open needle having a sharp tip and the open end having a blunt tip.

9. The pedicle screw guide as claimed in claim 2, wherein the cross post, the side posts, the needle way post and the bracing strut are integrally formed.

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